[CIS PIDD] [cis-pidd] Sweet syndrome associated with immune deficiency

[CIS-PIDD]

We have a 25 year old transgendered male with a history of severe Sweet's syndrome that has flared multiple times despite immunosuppression including steroids, infliximab, cyclosporine, hyperbaric oxygen, dapsone and colchicine.  He requires frequent hospitalizations for flares and does respond to high dose IV steroids.  His Sweet's syndrome has been attributed to his testosterone use as there is no other clear trigger (no malignancy, no IBD, no other drugs).  He has now been off testosterone for the past 3 months and continues to flare.  Given the severity of his Sweet's syndrome, we were asked to evaluate whether there might be possible associated immune deficiency.  There are reports of Sweet's syndrome associated with immune deficiency but there does not seem to be any clear association with any particular disorder but seems to be associated with chronic inflammation in the setting of immune deficiency.  He has been on significant immunosuppression so his testing is likely to be abnormal (we know he has hypogammaglobulinemia but in the setting of long term high dose steroids).  He has no history of infection prior to his diagnosis of Sweets about 15 months ago and no significant family history of infection, immune deficiency, or autoimmunity.
Thanks,
Rebecca Saff



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